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CMS requires that any Medicare service provided or ordered must be authenticated by the author - the one who provided or ordered that service. This article outlines acceptable forms of authentication.
FOIA (Freedom of Information Act) found in Title 5 of the United States Code, section 552, and enacted in 1966, provides that, upon request from any person, a federal agency or federal contractor must release any record unless that record f…
Prior to submitting your claim, verify the revenue code(s) and/or HCPCS or CPT code combination is correct, complete, and/or valid (as applicable).
The following reason codes are frequently associated with this edit:
View targeted probe and educate (TPE) round results for nail cutting / pairing and debridement (CPT 11055-11057, 11719-11721 & HCPC G0127).
DDE is designed for Medicare Part A providers. DDE will allow you to perform the following functions; claim entry, claim correction, claim status, claim adjustments, and inquiries.
View this special edition on recent CMS actions.
To enhance efficiency and ensure the secure handling of appeal information, all providers will be required to use SPOT to check appeal status and access duplicate appeal decision letters, effective December 1.
For the element of medical decision making addressing the amount and/or complexity of data to be reviewed and analyzed, the AMA Levels of Medical Decision Making table indicates: "Each unique test, order, or document contributes to the comb…
Use the left menu find tips to avoid common denials and claims rejections. Billing Medicare correctly the first time increases your cash flow while reducing provider burden.
Read this article for helpful hints for SNF claim reviews by CERT.